CS Duale Names Five Counties as Hotspots in SHA, NHIF Fraud Crackdown

Health Cabinet Secretary Aden Duale has revealed that the government has shut down more than 1,200 health facilities as part of a sweeping crackdown on alleged fraud involving the Social Health Authority (SHA) and the now-defunct National Hospital Insurance Fund (NHIF).

Appearing before the Senate of Kenya on Wednesday morning, April 22, 2026, Duale said investigations had intensified, with dozens of case files already escalated for prosecution.

He disclosed that the Directorate of Criminal Investigations (DCI) currently holds dozens of active files related to the alleged fraud.

“As we sit here, the DCI has close to 81 files, of which last week he submitted 24 more files to the DPP,” Duale said, adding that the ministry would not relent in fighting fraud.

More Than 24 Cases Sent to Prosecutors

According to Duale, the Office of the Director of Public Prosecutions (DPP) has received more than 24 case files, with at least 18 already taken to court.

Notably, some of the cases involve two former chief executive officers linked to both SHA and NHIF, signalling the seriousness of the ongoing probe.

The Health CS maintained that the government was determined to hold both individuals and institutions accountable for fraudulent claims that have strained the national health insurance system.

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Five Counties Flagged as Fraud Epicentres

Duale named five counties as key hotspots in the fraud investigations – Mandera County, Kisii County, Migori County, Homa Bay County, and Wajir County.

He described these regions as “epicentres” of fraudulent activities, noting that the investigations target both county systems and individual facilities suspected of wrongdoing.

The CS also cited facilities in Bungoma County among those affected by closures, specifically naming Bungoma West Hospital and 13 Calvary Hospital facilities in the county.

Majority of Fraud Linked to Private Facilities

Duale told senators that most of the alleged fraud was being carried out by private health facilities.

He added that the government had tightened scrutiny of medical claims, leading to the rejection of suspicious submissions.

According to the CS, claims worth 13 % of an estimated $1.2 billion had already been rejected due to irregularities or lack of supporting documentation.

Tighter Documentation Rules Introduced

The ministry has introduced stricter documentation requirements to curb fraudulent claims, particularly in sensitive cases such as maternity services.

Duale explained that maternity claims would be rejected if essential legal documentation was missing.

“The only thing that can tell us a child has been born is if you produce a legal document called birth notification,” he said.

He emphasized that the stricter rules were necessary to ensure transparency and prevent the misuse of public health funds.

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Duale Urges Leaders to Support Anti-Fraud Drive

The Health CS also appealed to political leaders to support the anti-fraud campaign and avoid interfering when health facilities are shut down.

He warned that the crackdown had generated resistance because some institutions were allegedly accustomed to exploiting specific benefit schemes, including those meant for teachers.

He said the crackdown had triggered “noise” because some facilities were used to stealing from specific schemes, including teachers’ benefits, adding that he planned to meet teacher union leaders to reassure them.

Duale further stressed that he would not intervene in cases involving suspected fraud, making it clear that enforcement actions would continue until integrity is restored in the national health insurance system.

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